在心力衰竭中使用阿尔多激素抗剂
Nancy M Albert1, Clyde W Yancy, Li Liang
1Nursing Institute and Kaufman Center for Heart Failure, Cleveland Clinic, Cleveland, Ohio, USA. albertn@ccf.org
JAMA
|October 22, 2009
概括
不到三分之一的符合条件的心力衰竭患者接受了指导方针推的阿尔多激素抗剂治疗. 处方率略有增加,但存在显著的医院变化,而不适当的使用仍然很低.
科学领域:
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 建议在中度至重度心力衰竭 (HF) 与静脉缩功能障碍时使用阿尔多激素对抗剂.
- 之前的研究表明,在符合条件的患者中使用量不足,在有害环境中过度使用.
研究的目的:
- 为了检查住院心力衰竭患者的阿尔多激素抗剂处方模式.
- 根据高温管理指南和适当性标准来评估处方率.
- 分析阿尔多激素对抗剂使用的趋势随着时间的推移.
主要方法:
- 从2005年1月至2007年12月期间,对43625名住院的高炎患者进行了观察分析.
- 使用了从Get With The Guidelines-HF质量改进注册表中获取的数据.
- 根据指南标准,研究了阿尔多激素抗剂使用的处方率和预测因素.
主要成果:
- 在12,565名符合条件的患者中,只有32.5%的患者在出院时接受了阿尔多激素抗剂.
- 在研究期间,处方率略有增加,从28%增加到34%.
- 观察到使用的医院级显著变化 (0%-90.6%);不适当的使用是低的.
结论:
- 在符合条件的住院心力衰竭患者中,只有不到三分之一接受了指导方针推的阿尔多激素抗剂治疗.
- 在具有禁忌的患者中,阿尔多激素对手的使用率很低.
- 在指南推的治疗中存在显著的差异.
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